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Cheeky

I have been derma rolling for the last 4 or so months (once every 4 weeks with a 3 line 1.5mm Roller (Dr. Roller) I roll quite aggressively and get lots of blood. However I am yet to see any results. However reading the boards and info on this site I believe that it’s still early days and changes won’t come about for a while yet?

However my concern is that for a week or so after rolling my skin looks worse, all the issues I am trying to rectify seem more prominent, the texture is dreadful!. To give you some info on me and my issues…..I am 34 years old and for the last 4 years have been battling with my skin as literally within in a matter of weeks it went for being OK/average to many many fine lines everywhere, orange peel skin texture and HUGE almost scarred pores all over my face. The most distressing thing for me however is that the pores on my cheeks turned huge and then collapsed into lines!, so now my cheeks have many fine lines which are actually large pores which have wrinkled/collapsed. I have seen a dermatologist and they were not able to determine any specific cause of such quick skin deterioration but said most likely it’s from use of sun beds from a teenager, not wearing sun screen and smoking until my late 20’s. For the last 4 years I religiously wear sunscreen, don’t use sun beds and quit smoking….too little too late maybe?

Anyway I am desperate to try and repair some of the damage done as I have honestly never seen anyone with skin like mine even people twice my age, you know if it were just a few fine lines, zits and crows feet that are in keeping with my relatively young age of 34 I can deal with of course! But not the severe textural skin issues I seem to have now, it seems completely abnormal compared to others. Over the last 4 years I have tried many things from Fraxel Repair, Laser Genesis, Chemical Peels but finally I decided to quit using lasers and peels as they were not giving me any results and in fact gave my skin some more textural damage as well as costing thousands of pounds.

For the last year I have been using Retin A 0.5 (Renova) and lots of moisturizer/squalane oil and gentle natural face washes. My skin hasn’t not gotten any worse and there may be slight improvement in some aspects but nothing outwardly visible unless you look closely. So I really want to work out the best routine for my skin issues and this is where I would really appreciate some advice please as maybe my skincare routine and method of derma rolling is not ideal. I have just ordered a derma stamp (1.5mm) and also a new 1.5mm roller as well as some Vit C Powder and a tube of Infadolan.

I have some questions if I may ask:

1) How to incorporate the Vit C serum I will make into my skincare routine which already includes Retin A each night? Which goes on first and can they even be used together or will it be too irritating? Can the Vic C Serum be used in the AM?

2) Is rolling pretty aggressively once every 4 weeks the right method for my skin issues, in fact do you think the derma rolling can really help my skin issues I describe in the first part of my post?

3) Do I use the Infadolan only post rolling for a few days afterwards when I am not using the Retin A? Or should I use the all the time as part of my skin care routine? Can it be used along with Retin A?

Thanks so much in advance for any advice or words of hope/wisdom that I can improve my skin over time

Cheeky

ps. I don't know if its possible to post/email a picture but I would be happy to do that if it gave you a better idea of my skin issues?

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Firefox7275

It is normal for skin to look worse before it looks better, microneedling causes quite a lot of damage to the skin barrier and means the skin is less able to hold water. The skin can sacrifice lower living layers to make a new protective stratus corneum (dead horny layer). Collagen remodelling takes many months in several stages so results are not overnight. Have you sought a second opinion from another dermatologist? It does not seem usual for skin to deteriorate so quickly: were you under a lot of stress, unwell or not eating properly around about that time?

Much of your medical history, current techniques and treatment you have tried on your skin are aggressive/ destructive; given how long collagen remodelling takes perhaps too many crammed into a short period of time. Did you adhere to the wait times advised by the dermatologist who treated you each time? What are you doing to repair the skin barrier, reduce inflammation, encourage healing, hydration and collagen production? What do you mean by a gentle wash, which product and does it contain sulphate surfactants and what is its pH? What moisturiser are you using other than the squalane? Are you exfoliating as well? Are you consistently meeting or exceeding ALL your government's recommendations for healthy eating and lifestyle?

Sorry more questions than answers! I am sure Sarah will be along to share the benefit of her experience on dermarolling soon.

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Cheeky

Ok that’s reassuring to hear that skin generally looks worse after a derma rolling session for a while. My skin does bounce back after a couple of weeks but I thought I would ask if that’s normal seeing as I have found this site now.

To answer your questions I did seek 2nd and 3rd opinions from various skin specialists and they said my skin wasn’t so bad and yes I was showing signs of premature aging a little more than usual it was nothing to worry about and put it down to my lifestyle in my younger years. However I am not happy about this because as I said in my first post I simply cannot believe that my skin changed so badly when people all around me live the same lifestyle and much worse and their skin is fine. Anyway my protests fell on deaf ears and I have just accepted that this happened and how can I fix/reverse it as much as possible They all advised about the use of sunscreen and healthy diet etc…which I have adhered to since these derm visits around 4 years ago.

Your right it does sound a lot of treatments, but they were over a 3 year period so actually it’s not as bad as it sounds and all done within correct/acceptable timelines of each other. However I do completely agree I was so panicked and distressed I just threw anything and everything I could to try and fix the problems a.s.a.p. I now know that was never going to happen. I needed to be kind to my skin and let it recover and heal. So that’s why for the last year I have not had any treatments and just concentrated on skin care and Retin A, then throw derma rolling into the mix around 4 or so months ago.

I am using an organic natural oil cleanser I buy from a health food shop and just oils (squalane and coconut oil) as much as possible and sometimes an Aveeno skin cream for dry skin. I also use Retin A most nights but sometimes take a break if my skin feels dry. My diet is good (I am a veggie, so lots of fruit and veg) I don’t tend of exfoliate but sometime use a damp micro derm cloth very occasionally.

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Firefox7275

Lifestyle is only one part of the equation, genetics is another. It is also extremely difficult to compare one lifestyle with another without doing a full case history as medical professionals and researchers do. You are not present when your peers eat every meal, you do not know how restful their sleep is nor to what extent they internalise stress, what their childhood diet and sun exposure was. Sorry to sound cheeky but I did not ask if your diet is good, I asked if you consistently meet or exceed all your government's recommendations for healthy eating and lifestyle - fruit and veg is just one of the many guidelines. Are you taking in plenty of long chain omega-3s from a marine algae supplement, 2-3g per day of combined DHA and EPA? Plenty of low glycaemic index whole carbs, a source of complete protein at every meal or snack and a balance in favour of monounsaturates over omega-6 polyunsaturates? I am pushing this angle because it is what I do for a living BTW! :innocent:

Recent research on the skin shows that the lipids in the stratus corneum are ceramides, cholesterol and long chain saturated fatty acids (stearic and palmitic). Some of us produce our own and have a healthy skin barrier, those of us with pre-existing dermatological conditions, who are older or who undertake aggressive skincare regimes may need support - unfortunately many plant oils supply unsaturated fatty acids which *may* cause abnormal changes to the epidermis, unusually coconut supplies short chain saturated fatty acids and is thus considered comedogenic (great for hair tho). Some of us also need to replace the skin's water-soluble Natural Moisturising Factors which are humectants like urea, lactic acid and glycosaminoglycans. You might also consider topicals proven to promote collagen production without any irritant or exfoliant properties. Bear in mind that much irritation/ inflammation takes place at the cellular level, IMO dryness or flaking on the surface is not mild it is a sign the skin is no longer functioning optimally.

Please email me a photo. It would make everything much easier. Let me know whether we are allowed to include the photo here.

I was thinking about your case and I find it very peculiar that your skin got so rapidly worse, although I did receive a couple of emails the past years with similar complaints - the skin rapidly aged and developed big pores, absent any obvious reason..

Cheeky

I don’t know about meeting government guidelines for healthy eating and lifestyle as I don’t know what the UK government recommendations are (I live in the UK). What I can say that I am healthy, not over weight at all in fact some may say I am underweight but I am very small/petite build., I do exercise and eat well and I drink at least 2 litres of water a day if not more, fizzy drinks once in a blue moon, I try to avoid caffeine so I only drink decaffeinated tea. No salt on my food. I take the following vits and supplements daily: 1000mg of Vit C (tablet form), Vitamin D, Omega 3, Vitamin E and finally a high quality broad spectrum multivitamin/mineral supplement for Vegetarians/Vegans. I am afraid I don’t know about long chain Omega 3 from Marine algae, I have never heard of this. What is DHA and EPA? Sorry for sounding so clueless! I would be very grateful for any advice/help you can give me.

Can you recommend any particular topicals I can use to promote collagen? It’s interesting that you say that about dryness/flaking at cellular level being a sign that the skin is no longer functioning properly as my skin is always so tight and dry yet very oily too. This is I believe dehydrated skin type? My skin used to be just oily but since my skins sudden deteriorated years ago its turned dry and tight yet still oily. I try to moisturize it as much a possible and do the right things in my mind to hydrate internally too (so lots of water, no salt on food etc…) I am not sure what else to do.

Dear Sarah,

I am not sure how to email you, can you tell me your email address and I will send you some close up pics for you to look at, I would really appreciate any help and advice as my skins condition is really affecting me and making me so self-conscious for the last 4 years, it really is bad…as you will see in the pics.

Firefox7275

I am from the UK too so you are making it easy for me! What does your GP have to say about your skin issues?

First official recommendation is eat the right amount to be a healthy weight! I am a small build too as are some of my clients, but you still should have a Body Mass Index of 20-25 (Google for a BMI calculator) OR if you prefer a body fat percentage of 20%+ as you exercise regularly. The older we are the more weight/ bodyfat is recommended, only a modest amount every few years. If you weigh too little or your body fat is too low this stresses the body out just as being overweight does. Your body will preserve the fat it has in case you fall pregnant or there is a famine (evolution has not caught up with modern life!) so it will starve your skin and hormones, if this carries on long term your fertility and bone density *may* be affected. Be aware that those who exercise regularly do not just need more calories than average but they need more of every nutrient, this can be double for someone training five times a week!!

Healthy eating ... Omega-3 is a big one because it is critical to the health of every cell in the body; guidelines are at least three portions of oily fish a week but obviously as a vegetarian you cannot do that. DHA and EPA are the two long chain omega-3s that are essential for humans and they will be labelled on any fish oil or marine algae supplement. Seed oils supply only short chain omega-3s which are healthy but not essential: these are converted to the useable long form at a rate of ~10%. Basically you need MASSIVE doses of raw seed oils to hit 2-3g EPA and DHA. Therefore vegetarians and vegans should take a marine algae supplement - these are available from health food stores, Amazon or eBay. No special brand, just look for the DHA and EPA essential fatty acid content. It is safe to go higher than 3g and you may wish to do so if you think you may be deficient. On top of omega-3s we need other healthy fats: as a vegetarian you may well already be meeting the target of 70g+ per day (female who is not dieting) from nuts, seeds, avocados, coconut and olive oil.

Fruit and veggies: UK recommendations are for a minimum of five 80g portions a day BUT the research actually supports nine portions. This should be from the full rainbow of colours - red , green, yellow, orange and purple/ black and can include beans/ lentils. Again you may well already be hitting this target. Don't get stuck in a rut, eat a wide selection over the course of a week.

Protein: recommendations are to choose reduced fat animal products and to limit portions of meat, both of which are not an issue for you! One of the biggest mistakes my female and my vegetarian clients make is not eating enough protein early in the day, our bodies cannot store spare so ideally we would eat some every three to four hours, especially if we are exercising regularly. If you like maths you are aiming for 1.5g-2g of pure protein per day per kilo of bodyweight and this helps to repair every cell in the body including the skin. Beans, lentils, eggs and soft cheese are super healthy but they contain half the protein of meat and fish - so you need to combine with another protein source or eat larger portions - hard cheese and nuts are much higher in protein. Whey (milk protein) powder is another good option for those who exercise; it should not replace real food, but is ideal if you cannot eat before or after a workout and can be added to fruit smoothies or vegetable soups to round a meal out. Makes a rubbish tasting shake unless you mix with powdered milk! Dairy: UK recommendations are at least three portions a day - a portion is 200ml milk OR 30g hard cheese OR 150g yoghurt/ cottage I think. Again you could well hit this target.

Carbohydrates: UK guidelines are a minimum of half of all grains to be wholegrains, for your skin this should be all of them and preferably all low glycaemic index (keeps blood sugar stable). Low GI carbs include sweet potatoes, boiled new potatoes with skins, most fruit and veg, beans and lentils, barley, jumbo/ steel cut (not porridge) oats, wholemeal pitta bread, granary stoneground bread, brown pasta and brown basmati rice. You may already know these supply minerals which are just as important as vitamins and of course fibre. You will need larger portions or to eat more frequently if you exercise regularly, always eat an hour before a workout and again within twenty minutes of finishing (enzymes that repair, regenerate and refuel are most active). Whenever blood sugar drops too low the body releases stress hormones, which can contribute to various health problems, including skin complaints.

Fatty and sugary junk food should be no more than 10% of daily calories. IMO this is a toughie because a cereal bar or packet of crisps can easily swallow this up. Bad news is that I count *some* vegetarian convenience foods/ meat replacements as junk, great if has a high pulse or nut content not so if the recipe is bulked out with breadcrumbs because it will be low in protein and high in empty calories. You may be wise to this supermarket scam already but, if not, Quorn is a better bet than most. Note that the sugar naturally found in milk officially do not count towards sugary foods and fruit is a grey area (it's healthy so don't count it). As long as my clients are not overweight I don't count the sugar or fats in small portions of good quality 70%+ cocoa dark chocolate either because it's full of antioxidants!!

I am sure you are closer to a balanced diet than the average Brit, but hopefully something in this essay will give you a :eureka: moment. I will respond to the collagen topicals question at a later stage if necessary, Sarah is more experienced than I so I think it best she responds when she has seen your photos.

Have you ever been on Accutane? Before your skin texture turned bad, did you have dermabrasion or a very deep acid peel done? Any other skin treatment you remember?

The reason I ask is because it almost seems like the top layer of your skin is "missing". In some cases, deep ablative methods can enlarge pores. The diameter of skin pores is usually larger in the deeper skin layers. If you abrade layers of skin, it can uncover a wider diameter of the pores.

A mild acid peel on the contrary often temporarily improves the appearance of skin pores.

Unclogging pores can slightly shrink their size - because then they are not dilated by debris - nevertheless, clean pores may also appear deeper because the debris basically fills in the pore and makes it flat.

Can you tell me what the origin is of the larger scar beside your lip?

The scar on your cheek that looks like an acne scar, have you always had it?

Cheeky

WOW you have given me lots and lots to think about with regards to my diet as reading this I realize there is a lot I can probably improve upon even though I think I eat pretty healthily.

Firstly let me tell you what my GP said about my skin went I went to see him after the sudden deterioration….he said there is nothing majorly wrong with it, the thing is in some lights my skin does not look so bad, if I could have showed him in natural daylight maybe he would have been more supportive…who knows? The thing is I realize this is deemed as a cosmetic issue I suppose rather than a medical issue so the doctors are not interested. Hence why I saw a dermatologist privately. In fact I got so distressed about my skin the doctor advised I might be a bit depressed and therefore my mind was magnifying my perceived issues about my skin and tried to put me on anti depressants, he is right I was very depressed but about the sudden deterioration in my skin not about life in general.

I just worked out my BMI using NHS calculator online and it comes out as 19.55 which is within healthy weight range according to the result summary. I am 5ft 2” and weigh 7st 9lb – 7st 10lb. (usually 7st 7lb but put on a couple of pounds over Xmas). I am a size 6/8 depending on the store. Even though I am this weight I feel I should lose more as I seem to have a lot of fat around my tummy and and lumpy bits in general :-S (I am what is known as an apple shape I believe). Even 2 -3lb weight gain is very noticeable on me as I am very small boned I guess. So I would like to try and lose the 2 -3 lbs to get back to my usual weight.

A typical days eating for me is:

AM: 3 x Wholegrain Ryvita crackers eaten over the course of the morning (no butter or spread) (never hungry in the morning) (37 cal per cracker but realize I need to eat something) = 111 cal ttl, 2 – 3 cups of weak de-caf tea with skimmed milk and one sweetner and 2 – 3 glasses of water. I have to confess that this is during the week when I am at work, at the weekends I will normally skip breakfast as just not hungry until lunchtime.

Snacks PM – Apple/pieces of fruit and couple of cups of weak de-caf tea and couple of glasses of water.

PM – Homemade vegetable, quorn and lentil (or some kind of pulse) soup or goulash with whole meal pitta bread or 2/3 x Ryvitas again (no spread) OR bowl of wheat free/gluten free pasta with small tea spoon of organic pesto sauce mixed though and a sprinkle of low fat cheese on top OR jacket potato with a small piece of half fat butter and mixed salad on the side with small covering of balsamic dressing. A piece of fruit for dessert. = 450 cal? A pint of water during the evening and I take a pint of water to bed with me to drink through the night.

Snack for me are unsalted nuts such as cashew nuts or some olives and occasionally I do have the odd naughty thing such as a chocolate bar or a packet of crisps but this is maybe once a week no more frequent than that.

Now the above is based on a good day. But lot of my socializing is based on food, so going out for dinner etc or dinner parties round at friends so I tend to eat out at least twice a week with friends or with my husband and I have to be honest then I just eat whatever I fancy, being vegetarian (and no eggs or fish) a lot of my meals out are based around pizza and pasta dishes and a fair bit of wine too. We also sometimes have the odd Indian Takeaway (once every two weeks on average)

Exercise wise I use an exercise bike 3 times a week for half an hour at quite a high resistance level will and be trying to up this to 4 times a week soon. I am also planning to get back into jogging maybe once a week in the near future.

So reading this back I can see that there are ways to improve my diet for sure. I would be interested to hear what you think of my food habits from a nutritional point of view and if you think there is any way I can improve it which would help my skin from the inside?

I am going to look into purchasing DHA and EPA supplements today also.

Thanks a lot

Cheeky

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Cheeky

1) I have never been on Accutane. And before my skin suddenly deteriorated I had never had any skin treatments such as peels/dermabrasion or laser. All I had ever done was cleanse and moisturize my skin in the usual manner as I had done for many years prior. In fact I distinctly remember when my skin started to change. One day I noticed for the first time ever that the pores on my nose where looking larger and sunken so looked for ways to cover them up and bought some Clinique Pore Minimiser. I didn’t think too much of it but little did I know then that within a matter of weeks my whole face would dramatically change too ***sigh*** The picture you posted is of my skin at its worst BUT before any laser or chemical treatments, when I took the picture I hadn’t started my quest to try to resolve the issues.

2) The larger scar above my lip is the result of a dog attack when I was 3 years old so I have always had it. In fact I should mention that this scar to date has changed, in that its significantly filled in and much more closed and smaller since I started my quest to fix my skin, this gives me hope the rest of skin can be improved.

3) I have always had the acne scar on the side of my face since I was a teenager. I have never suffered from acne but was your average zitty teenager who couldn’t help but pick!, this cleared up once I was out of my teens. I have always been prone to the odd spot every so often as my skin is oily but never acne.

4) The textural damage I have sustained from the laser is isolated to just below my right eye, you can see if you look closely the laser track marks from the Fraxel Repair laser and also slightly by the side of my nose on the right hand on the inner part of my cheek. These are fading a lot and not noticeable to anyone but me, but it was enough to make me realize that lasers are not the way to go and in most cases can do some damage and at best do nothing, well that is my experience anyway.

If you have any other questions please let me know and I look forward to any advice or hearing if in fact you think derma rolling can help my skin texture in the long run.

I am trying to figure out what caused the deterioration of your skin texture. Another factor that can affect skin pores is sex hormones (as almost all of us experienced in adolescence when the levels of these hormones shoot up). Did you have any hormonal problems or changes before or at the time of your skin worsening - missing periods, pregnancy, hormonal contraception? Email me your answer if you do not want to answer this question on the forum.

Concerning dermarolling, I am not sure what to expect because you underwent a Fraxel Repair procedure, which is a very intensive treatment. It vaporizes fractions of the skin and can go up to 1.6 mm into the skin. It works on the same principle as dermarolling - causing very small skin injuries not serious enough to become a scar but big enough to trigger healing/regeneration processes that result in improved, rejuvenated skin.

Lasers injure the skin by heat, dermarollers do it mechanically.

Since you underwent a treatment that is based on the same principle and did not get any results, I do not think you can expect miracles from dermarolling.

We have a customer who had a similar problem as you - her skin texture quickly deteriorated and I contacted her some days ago to ask whether dermarolling helped her. She replied and said she would post here to describe her experience. Her skin texture improved a little. If she is too busy to post here, I will ask her permission to post here anonymously her last email.

Firefox7275

Cheeky that restrictive diet could explain why the aggressive treatments have not worked for you, there is not nearly enough overall food nor enough of a host of nutrients given that you exercise regularly. Your 'apple' shape may be partly down to genetics, partly what you are doing exercise wise and partly your diet. If you don't eat enough and/ or don't eat enough protein your body will break down your muscles for energy, this slows your metabolism. Gaining weight in the abdominal area can indicate a stressed body, but the main problem is probably the eating out and drinking - alcohol cannot be converted to energy so goes to fat, particularly in the abs area. Ditto the food because your body is stuck in a feast and famine cycle. However research suggests we CAN spot reduce fat from our abdominal region with the right diet and the right physical activity. What happened around the time your skin first deteriorated, was it preceded by any changes in your eating habits, physical activity, stress levels or lifestyle?

Breakfast

You should not need to be hungry to eat any more than you should need to be thirsty to drink, train your body to accept a substantial meal first thing. Your current breakfast is too low in overall calories, low in protein and low in essential fats, so stop filling your stomach with six zero calorie drinks and start filling it with fruits and a source of protein. A homemade smoothie made with ~160g mixed frozen berries, a large banana, a scoop of whey powder and a little milk tastes delicious and is liquid enough to go down easily. Quick to make with a stick blender and often popular with partners and/ or children!!

Eat stacks daily! Always include protein plus healthy fats if you know your breakfast or lunch are short. Make this your second breakfast if you eat something light first thing.

Lunch

Lunch is low in essential fats and low in complete protein - combine pulses/ grains/ nuts remembering the body cannot store spare, it will rob from your muscles (including the heart!). Salad leaves are not the best for daily use simply because an 80g portion is MASSIVE. A bean salad is an opportunity to eat brightly coloured veggies - one green, one red, one yellow and one brown/ white looks good.

Again: eat snacks! Always include protein plus healthy fats if you know your lunch or dinner are short. Especially snack if you are doing intense exercise or eating late in the evening.

Dinner

Low in essential fats and low in protein. What is in the wheat-free pasta? Often these are refined, high glycaemic index carbs.

I love wine - really struggling with making January a dry month - but it is hell on my skin: I experience dehydration, dullness, rebound eczema, enlarged and clogged pores. IMO pick between the drink OR an unhealthy meal on social occasions. There are a couple of healthy eating dinner party books for when you are on cooking duty: Gordon Ramsay 'Healthy Appetite' and Michel Roux 'Marathon Chef' that might have some meat-free choices, or Simon Rimmer's 'Accidental Vegetarian' and 'Seasoned Vegetarian'. You may already know that anyway! You also might be sneaky and research local restaurants online that get great reviews and offer a selection of healthier veggie options? Chances are some of your friends are also keen on weight management. In a restaurant I often ask for extra vegetables instead of half the carbs in my meal and if I have an Indian takeaway I choose daal and/ or brown chapattis instead of white rice and/ or naan. Another thing to do is steam your own brown basmati rice (Delia Smith method or a rice-cooking gadget) and keep it in the freezer. Reheats great in the microwave with a splash of water.

This absolutely should help your skin if your commit to the change, you will be supplying the right nutrients and antioxidants for repair and maintenance, helping it to hydrate from the inside. It will also take your body firmly out of a state of stress, and reduce the chronic inflammation that is a major cause of ageing. Will it resolve your skin texture completely? I don't know, it depends whether the structure of your skin has been permanently altered by the laser. I would combine this with super babying and nourishing your skin from the outside, give it a couple of months before you dermaroll or do any peels.

Cripes another essay, sorry I type fast! :duh: Will comment on exercise/ weight management/ body shaping next if you wish.

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Firefox7275

Hi Sarah: Sorry to see churlish but I am not comfortable with my new title as it does not accurately reflect my work background. I actually hold qualifications in a couple of biological disciplines but currently work in lifestyle healthcare. I have stated categorically on other forums that I am not a nutritionist because dietetics is only one aspect of my role, and do not want to lose credibility by appearing to claim the opposite here. Hope that makes sense, if you think a title would help I would prefer something using the word health or healthcare. :confused: